Life goes on.

Things are finally starting to return to normal again. Sera is feeling better and I am having flashbacks less often about what happened to Dixie. Now I can actually sit down with a clear mind and update you guys on my exciting experiences last week.

First thing we had was the Simman session. Like I mentioned before, Simman is a simulation model of real-life patient. He has pulses, heart beats, and lung sounds. He can talk, moan, vomit (sound effect), and cough. We can measure his pulse, EKG, temperature, respiratory rate, and blood pressure and read the results from a monitor. The facilitator that was leading our session controlled what symptoms the patient would present all through a small touch-screen computer according to the specific disease assigned to our group. It was a 1hr session, but it went by fast. No one in our group had any ER experience so it was a bit of a gong show at the start. But we quickly organized ourselves better. Under the guidance of the facilitator and the direction of a group leader, we bounced questions and differentials off one another. It was great. I almost felt like a doctor (I would have REALLY felt like one if I knew what I was doing)! I heard crackles in the lower lobe of the right lung (pulmonary interstitial edema) - got me so excited! Anyhow, with some help we diagnosed our patient - H1N1. Unfortunately none of us in the group wore a mask... so we were all 'infected'. Definitely a good lesson - wear gloves AND a mask! Our facilitator said to us, 'Congratulations, your patient lives... but y'all now have H1N1.'

Then on Thursday I went to the Princess Margaret Hospital (3 ICM groups) for our first rotation as a 4th semester student. We took a bus to PMH, which took about 1hr, and received our assignments for the day. I requested surgery but did not get it - apparently too many students requested for it! But I was assigned to Internal Medicine, which was amazing as well! The wards at PMH were old school: a dozen or more beds packed tightly together, separated my a curtain. The hospital appeared slightly run down but nevertheless tidy with some new renovation projects going on. The offices were small but the desks were still full with patients' charts. The doctors here recorded everything by hand, a system that is rapidly replaced by computerized sorting/recording in N.Am. hospitals. Our Internist was amazingly knowledgeable AND extremely friendly (I was surprised...)! We saw about 9 patients in 2-3hr or so and they all had different signs and symptoms. The beautiful part was that I have learned about most of the cases presented! What a wonderful review (and reminder of how much harder I should study)! By noon, I was already pooped. But I still had 6 more hours to go.

In the afternoon, we were divided up into even smaller groups to do our patient interview and physical exams - this time, it was real :) Due to confidentiality I will only mention that our patient was 2wk post-op from an AP (abdominoperineal) resection. He had a colostomy bag attached to his lower left abdomen. Long story short, we finished at around 4 30pm, met with the surgeon (super friendly, once again), and discussed the case. I had such a great day but was completely drained - hungry, and tired.

The bus ride home was long but I didn't mind it too much. Got home, took a nap, and got back to studying. Lots to learn... and I am looking forward to it!

ps. Enjoy a recent picture of Miho. He is so handsome!